Lien H H, Blomlie V, Tropé C, Kaern J, Abeler V M
Department of Diagnostic Radiology, Norwegian Radium Hospital, Oslo.
AJR Am J Roentgenol. 1991 Dec;157(6):1221-3. doi: 10.2214/ajr.157.6.1950869.
The depth of invasion into the myometrium correlates with the frequency of lymph node metastases in patients with cancer of the endometrium. A distinction between superficial invasion (less than 50% of the thickness of the myometrium) and deep invasion (greater than 50%) is particularly important. The ability to distinguish between these two groups on MR was studied in 33 patients with endometrial cancer who had primary hysterectomy. The overall accuracy of MR in showing deep invasion was 82%, with a sensitivity of 91% and a specificity of 64%. The main limitation of MR was four false-positive results with regard to deep invasion. In all of these, the erroneous diagnosis was found at histologic examination to be due to a large polypoid tumor that distended the uterus so that a thin rim of myometrium was stretched over it rather than being deeply infiltrated by it. Our experience shows that MR can be used to distinguish between superficial and deep invasion of the myometrium. However, degree of invasiveness may be overestimated in exophytic polypoid tumors with significant intraluminal extension.
子宫内膜癌患者肌层浸润深度与淋巴结转移频率相关。区分浅肌层浸润（小于肌层厚度的50%）和深肌层浸润（大于50%）尤为重要。对33例行原发性子宫切除术的子宫内膜癌患者进行了研究，以评估磁共振成像（MR）区分这两组的能力。MR显示深肌层浸润的总体准确率为82%，敏感性为91%，特异性为64%。MR的主要局限性是在深肌层浸润方面有4例假阳性结果。在所有这些病例中，组织学检查发现错误诊断是由于一个大的息肉样肿瘤使子宫扩张，以至于一层薄的肌层被拉伸覆盖在肿瘤上，而不是被肿瘤深深浸润。我们的经验表明，MR可用于区分肌层的浅浸润和深浸润。然而，对于具有显著腔内扩展的外生性息肉样肿瘤，浸润程度可能被高估。
